90-90-90 Goals at Durban’s International AIDS Conference

Durban, a popular ocean city on the Eastern coast of South Africa, played host to more than 6,000 local and foreign guests including individuals from all walks of life for the 21st International AIDS Conference (18/7/16 – 22/7/16).

Filled with watershed moments, the Conference brought dignitaries, activists and politicians together including South Africa’s Health Minister Aaron Motsoaledi, Canada’s Health Minister Jane Philpott, South Africa’s Salim Karim (Center for AISDS Program of Research in SA), Bill Gates, Sir Elton John, and Prince Harry. Amongst all the dignitaries, however, were the true heroes and heroines – the individuals who work in townships and cities around the world in order to halt HIV transmission and reduce the stigma etched into HIV infected members of our societies. As someone who attended the Conference, I was fortunate to meet some of these champions including Loyce Maturu (representing Africaid Zvandiri in Zimbabwe), Carlo Rodriguez (representing Adolescent HIV Treatment Coalition in Puerto Rico), Aaron Siegler (representing Emory University in the USA), and my dear friend Boitumelo Marumo – a colleague from Botswana (pictured below).

As a student attending the conference, I was overwhelmed by the energy and passion exhibited on and off plenary stages. Whether I engaged with health ministers or community health workers, I found an equal commitment to fighting HIV/AIDS – because “no” is no longer an option. How wonderful that the Conference could mark the coming-together of many great minds amongst the fear and terror rife in our societies this July. Each night when I turned on the TV after a fantastic Conference day, I found death tolls rising in CNN’s headlines and carnage in every corner of the world. The pseudo state of war we are in seems to detract from issues we need to be focusing on. When will we realize that AIDS is the real killer?

16 years ago, in 2000 at the 17th International AIDS Conference hosted in Durban, the world was very different than today’s international attacks, political warfare, and daily funerals. It was at that conference, in 2000, that South Africa’s Former President Nelson Mandela invited 11-year old Nkosi Johnson onto the stage. Johnson, a child living with HIV and full-blown AIDS, shared his experience with the world in a thought-provoking speech that changed the life of every person in the audience. Johnson brought to the fore the fact that most of the world was in denial about HIV/AIDS. The globe refused to acknowledge the inevitable rise of the epidemic. Johnson highlighted the stigma attached to HIV – something that many speakers emphasized in this year’s conference. Had Johnson been alive today, 16 years later, he would have continued his fight as a 27-year-old HIV activist.

But he is not alive – despite the fact that 3.4 million people have been on ART since the end of 2015. He is not alive – despite the fact that in South Africa, specifically, AIDS deaths have declined from 410,000 in 2008 to 180,000 in 2014. Despite the fact that Mother-to-Child Transmission (MTCT) has reduced from 8% in 2008 to 1.5% in 2015. Despite the fact that the cost of HIV treatment has decreased from US$10,000 per person per annum to US$0.20 per person per day. Johnson is no longer with us. Countless Brothers and Sisters are no longer with us because their lives were claimed by HIV/AIDS.

Today, there are 37 million people globally who are HIV positive and require HIV treatment. A mere 17 million of these individuals have access to treatment. Additionally, there are 3.3 million children living with HIV – only 32% of whom will receive ART. There is a marked need for innovation and access to treatment – both requiring funding and social cohesion. To meet this need, international slogans have begun circulating since the conference started a week ago. These include slogans such as “Fund the Global Fund” and “Zero Stigma – Zero Discrimination” – both trumped by the popular favorite “90-90-90.”

The “90-90-90” Goals were issued in 2000 as a strategic plan for the world’s fight against HIV/AIDS. As per the Goals, which pertain to the global population: 90% of the world should know their HIV status, 90% of the world should be on antiretroviral treatment (ART), 90% of the world should be virally suppressed – all by 2020.

These are lofty goals, and I will be the first to admit this along with countless international speakers at last week’s Conference. But these goals are feasible. Why? Because we know how to achieve them. For the first time since the war against HIV/AIDS started, we have the means and technology to end the epidemic. We have low cost ART, MTCT medications, early testing and prevention, and Pre-exposure Prophylaxis (PrEP). PrEP is a recently released pill that can be taken by people at risk for HIV in order to prevent the infection. For the first time ever, there is a safe drug available that can prevent HIV infection.

Yet among the ingenuity and innovation we see cultural stigma and discrimination in our societies. Thus, I believe our greatest tool in this global fight is love. It may sound unrealistic or impractical, but the truth remains that the greatest ‘progress’ in the fight against HIV can be made if we have love – because love grows compassion and empathy. If we can truly love a fellow human being who is suffering from or at risk for HIV/AIDS, then we can begin to want to work to prevent their suffering. Instead of simply ‘working’ to fight HIV, we will want to fight HIV – and end it.

Despite the long way we have come, we have a longer road ahead. And we must walk together.